Venomous bites and stings, Key points 2017–18 In 2017–18, 3,520 people were hospitalised due to Published March 2021 contact with a venomous animal or plant. Almost This report describes injury hospitalisations due to contact with twice as many males as venomous animals and plants in Australian hospitals in 2017–18. females were hospitalised. Australia has a wide diversity of venomous animals and plants, The highest rate of found in both terrestrial and marine ecosystems. These include hospitalisation due to snakes, spiders, jellyfish and insects, all of which are capable of contact with venomous inflicting fatal bites or stings. Australia has 66 venomous species, animals and plants some of which have the deadliest venom in the world. occurred in the Northern Territory (31 cases per Some of the world’s most venomous marine animals are found 100,000 population). in Australian waters; the box jellyfish, Irukandji jellyfish, marbled cone snail, blue ringed octopus and stonefish are among the The brown snake was world’s top 10 most venomous animals (AVRU 2020). responsible for 215 of the Australia is also home to 20 of the 25 most venomous snakes in 606 hospitalisations due to the world, including the top 10. The world’s most venomous snake, contact with a venomous the inland taipan, is found nowhere else on earth (AVRU 2020; snake. Swan 2020). There were 41 The toxicity of venom is only one aspect of what makes bites and hospitalisations due to stings dangerous. Allergic reactions to the venom of bees and ants contact with the Irukandji can also lead to hospitalisation and death. jellyfish. Fortunately, deaths due to contact with venomous animals Bees were the most and plants are rare. The National Coronial Information System common type of recorded 19 deaths in 2017–18 due to contact with venomous venomous animal animals (7 with venomous snakes and 12 with bees and wasps). responsible for Nonetheless, many bites and stings due to contact with venomous hospitalisations in species result in admission to hospital each year 2017–18. in Australia. Stronger evidence, better decisions, improved health and welfare Hospitalisations due to contact with venomous animals or plants In 2017–18, there were 3,520 cases of hospitalised injury due to contact with a venomous animal or plant (Table 1). The overall rate of hospitalisations was 14 cases per 100,000 population, with almost twice as many males as females hospitalised in 2017–18. Table 1: Number and rate of injury hospitalisations due to contact with a venomous animal or plant, by age and sex, 2017–18 Males Females Persons Number of cases 2,206 1,314 3,520 Age-standardised (per 100,000 population) 17.9 10.5 14.2 Notes 1. Cases include those that have an external cause code anywhere in the record of X20–X29 Contact with venomous animals and plants. 2. Age-standardised to the 2001 Australian population (per 100,000), using 6 age groups (0–4, 5–14, 15–24, 25–44, 45–64, 65+). 3. Data underpinning this table can be found in the accompanying supplementary spreadsheets. Source: AIHW National Hospital Morbidity Database. Which species are included? The category Contact with venomous animals and plants (X20–X29) contains codes covering a wide variety of venomous animals and plants. Within each subcategory, further detail is available on different species, most of which are specific to Australia. The categories are as follows: X20 Contact with venomous snakes and lizards X21 Contact with spiders X22 Contact with scorpions X23 Contact with hornets, wasps and bees X24 Contact with centipedes and venomous millipedes (tropical) X25 Contact with other venomous arthropods (includes ants, ticks and caterpillars) X26 Contact with venomous marine animals and plants (includes jellyfish) X27 Contact with other specified venomous animals X28 Contact with other specified venomous plants X29 Contact with unspecified venomous animal or plant. Identifying the species that caused a bite or a sting is not always a simple task. The victim may misidentify the animal or plant causing the bite or sting (for example, identifying it as a brown snake when it was a black snake) or not have seen it. Only a limited number of snake species can be identified using a venom detection kit. Length of stay for bite and sting cases The length of stay for hospitalised venomous animal and plant cases was generally short. Just over half of all cases were discharged on the day of admittance to hospital (51%, 1,794 cases). Nine of every 10 cases had a length of stay of 2 days or less (3,369 cases) and fewer than 1 of every 100 cases had a stay in hospital of more than a fortnight (10 cases). A large proportion of venomous animal and plant cases occurred among older Australians, with almost half (46%) occurring in those aged 45 and over (Table 2). It was a similar pattern by age for males and females. 2 Venomous bites and stings, 2017–18 Table 2: Number of venomous animal and plant injury hospitalisations, by age and sex, 2017–18 Males Females Persons Age group (years) Number % Number % Number % 0–4 98 4.4 59 4.5 157 4.5 5–14 233 10.6 110 8.4 343 9.7 15–24 241 10.9 136 10.4 377 10.7 25–44 673 30.5 357 27.2 1,030 29.3 45–64 656 29.7 457 34.8 1,113 31.6 65+ 305 13.8 195 14.8 500 14.2 Total 2,206 100.0 1,314 100.0 3,520 100.0 Notes 1. Cases include those that have an external cause code anywhere in the record of X20–X29 Contact with venomous animals and plants. 2. Percentages may not sum to 100 due to rounding. Source: AIHW National Hospital Morbidity Database. After adjusting for age and sex, the rate of hospitalisations due to Contact with venomous animals and plants was higher for males than for females for each age group examined (Figure 1). The highest rate of hospitalisation was 22 cases per 100,000 population in men aged 45–64. The rate of hospitalisations for women in that age group was 15 cases per 100,000, which was also the highest rate for females in any age group (Figure 1). Figure 1: Age-specific rates of venomous animal and plant injury hospitalisations, by age and sex, 2017–18 Rate per 100,000 population Males Females 30 20 10 0 0–4 5–14 15–24 25–44 45–64 65+ Age group (years) Notes 1. Cases include those that have an external cause code anywhere in the record of X20–X29 Contact with venomous animals and plants. 2. Data underpinning this chart can be found in the accompanying supplementary spreadsheets. Source: AIHW National Hospital Morbidity Database. Venomous bites and stings, 2017–18 3 The rate of hospitalisations due to venomous animals and plants varied by state or territory of usual residence (Figure 2). The highest rate of hospitalisations occurred in the Northern Territory (31 cases per 100,000 population) and the lowest in the Australian Capital Territory (9 cases per 100,000). The distribution of hospitalised injury cases according to the person’s state of usual residence largely reflected the known distributions of Australia’s venomous species and/or the expected level of exposure to these creatures (AIHW: Bradley 2008). The rate of bite and sting cases involving venomous animals and plants that required hospitalisation in 2017–18 increased linearly according to the remoteness of the person’s place of usual residence (Figure 3). Residents of the Major cities of Australia had the lowest rate of injury hospitalisations (9 cases per 100,000 population) while the highest rate was observed for residents of the Very remote regions of Australia (49 cases per 100,000). Figure 2: Age-standardised rates of injury hospitalisations due to Contact with venomous animals and plants, by state or territory of usual residence, 2017–18 Rate per 100,000 population 40 30 20 10 0 NSW VIC QLD WA SA TAS ACT NT State or territory of usual residence Notes 1. Cases include those that have an external cause code anywhere in the record of X20–X29 Contact with venomous animals and plants. 2. Age-standardised to the 2001 Australian population (per 100,000), using 5 age groups (0–14, 15–24, 25–44, 45–64, 65+). 3. Based on the patient’s state of usual residence. 4. Data underpinning this table can be found in the accompanying supplementary spreadsheets. Source: AIHW National Hospital Morbidity Database. 4 Venomous bites and stings, 2017–18 Figure 3: Age-standardised rates of injury hospitalisations due to Contact with venomous animals and plants, by remoteness of usual residence, 2017–18 Rate per 100,000 population 40 30 20 10 0 Major cities Inner regional Outer regional Remote Very remote Remoteness of usual residence Notes 1. Cases include those that have an external cause code anywhere in the record of X20–X29 Contact with venomous animals and plants. 2. Age-standardised to the 2001 Australian population (per 100,000), using 6 age groups (0–14, 15–24, 25–44, 45–64, 65+). 3. Data on the remoteness area of usual residence are defined using the Australian Bureau of Statistics’ Australian Statistical Geography Standard Remoteness Structure 2011. 4. Data underpinning this table can be found in the accompanying supplementary spreadsheets. Source: AIHW National Hospital Morbidity Database. Type of venomous animals and plants The most common category of venomous animal responsible for hospitalisations in 2017–18 were hornets, wasps and bees (Table 3).